When in shock, casualtiemay wander off. They should be collected together so that they can be watched athey wait to be treated. Usually by thistage people are beginning to want to help, but often they are not sure what to do. Remember that you are also in a potential crime scene. If it waa bomb, you are at the scene of at least five murderbecause you can see five dead people. Anyone around may be a witness. If they are not injured, get them to stay and help or at least wait to be questioned, then they will be available to talk to the police when they arrive.
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Keep your earopen and listen to what ibeing said. If anyone seemto know what happened, insist that they stay with you to talk to the police when they arrive. Try not to let anyone who knowanything go. Keep them around you or at least insist that they give you their contact details. major incident ientirely outside the experience of most people. They are lost and do not know what to do. Many want to help but are in shock. Most people will take sensible orderfrom somebody who seemto be calm and seemto know what to do. To start with you may be the only person at the scene who can organise assistance for the casualties.
With a major incident, normal first-aid skilland abilitieare usually overwhelmed. The average first-aid-trained person will not know what to do with an amputation, seriouburnor crush victims. Don’t try to be clever. The one part of basic first-aid training that workin a major incident ithat the noisy onecan usually look after themselves. Stop to look at them, staunch bleeding, reassure them and offer them support, tell them that they will be OK but move on to the more seriouinjuries. Stop bleeding abest you can. If somebody inot breathing, clear the airway and if necessary give mouth-to-mouth resuscitation. If at all possible, instruct somebody to carry on with it while you do something else. People in shock can follow orderbut may be in no fit state to decide what to do on their own.
Look for anyone who itrapped, or at risk from fire or further collapse. Make best effortto rescue them without putting anyone else at risk and without causing additional injurieto the casualty.
After the first shock, more people should be arriving to help. I would direct them to moving the walking wounded to a safe area, where paramedicand ambulance staff will have the space to set up and treat them. A supermarket car park would be ideal for this. You will be updating the emergency serviceall the time, so you should have told them that 25 walking wounded are now sitting on the wall outside Bigginsupermarket waiting for treatment. Get the new helperto stay with the walking wounded to reassure and support them.
If you have any time left, you should go back to check on the seriously injured, make sure that their helperare still with them, and make sure that the two key actionare being done – keep them breathing and stop them bleeding.
When the emergency serviceturn up, go and talk to them. You possibly know more about what hahappened than everyone else at the scene. Update them, then hand over to them so that they can do their job. Each emergency service will have itown incident control for a major incident, so there will be a senior police officer, senior fire officer and senior ambulance officer.
Though any explosion and fire should be self evident, point them out to the police and fire brigade. Explain what you know about fires, gaand petrol escapes, dangerouwalland other dangerand leave them to it. If you are still in telephone contact, tell the emergency operator that the fire brigade (or whoever) haarrived and pason other similar detailalong athey want you on the line
Tell the paramedicwhere what you consider to be the serioucasualtieare, and if you have any idea explain which you think should be the priority cases. Point out where you have sent the walking wounded. Explain that you picked that area because it havehicular access, plenty of space for turning and parking, with direct accesback out onto the main road (if you are lucky enough to have that nearby). Tell the emergency operator that the ambulancehave arrived, including how many ambulanceif you are still on the phone.
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